| National Provider Identifier [NPI]: | 1598741118 |
| Last Name Of The Provider | ANEZ |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9765 SAN JOSE BLVD |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322574402 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6930 |
| Number Of Medicare Beneficiaries | 1137 |
| Total Submitted Charge Amount | 836713.59 |
| Total Medicare Allowed Amount | 568697.26 |
| Total Medicare Payment Amount | 426047.29 |
| Total Medicare Standardized Payment Amount | 429615.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 256 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 8258 |
| Total Drug Medicare AllowedAmount | 1655.9 |
| Total Drug Medicare PaymentAmount | 1472.19 |
| Total Drug Medicare Standardized Payment Amount | 1472.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 6674 |
| Number Of Medicare Beneficiaries With Medical Services | 1137 |
| Total Medical Submitted Charge Amount | 828455.59 |
| Total Medical Medicare Allowed Amount | 567041.36 |
| Total Medical Medicare Payment Amount | 424575.1 |
| Total Medical Medicare Standardized Payment Amount | 428143.29 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 319 |
| Number Of Beneficiaries Age Greater 84 | 419 |
| Number Of Female Beneficiaries | 741 |
| Number Of Male Beneficiaries | 396 |
| Number Of Non Hispanic White Beneficiaries | 910 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 415 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8935 |